Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Nicole Etta Jackson, DO

Individual provider Family Medicine Physician · NPI 1578084927

Dr. Nicole Etta Jackson, DO is a Family Practice in Augusta, Georgia. Qualified in 2017, 9 years ago. Practices with Legacy Healthcare Services Inc, a 3,624-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
9
Licensed in
GA
In the registry since
2017
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1120 15th St
Augusta, GA 30912-0004
Phone: (706) 721-7005
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 009754 (GA)

Record details

NPI number1578084927
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedJuly 6, 2017
Last updated in NPPESJuly 6, 2017
Mailing address269 W Vineland Rd, Augusta, GA 30904-3418

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Legacy Healthcare Services Inc — 3624 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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